National Healthcare
Quality Week is October 18-24, 2015.
Any of us who are involved with healthcare
should take a moment to celebrate some of the measurable achievements in
healthcare quality on improved patient care outcomes.
Each of us make a
difference - Administrators, Nurses, Therapists, Social Workers, Nursing
Assistants and all who contribute to a patient's healthcare experience.
I have been a health care professional and leader
for the past 30 years. In my 30 years of
practice as a Nursing Home Administrator, Registered Nurse, Public Health
Professional, Home Health Provider and now as an Acute Care Compliance Officer,
I have never seem a time more dynamic than the past five years. "Syzergy"
is a term in astrology that means alignment
of planets/celestial bodies. I believe
that we are in a time of healthcare syzergy, one where there is alignment of
political, financial and consumer forces working to change the landscape of
healthcare and demanding improvements in both the value and quality of U.S.
healthcare.
Health Care Quality Improvement , like leadership, is part science and
part art . I believe that the Affordable
Care Act (ACA) and other policy initiatives have had a significant impact on
quality of care. The increased focus on
public reporting, transparency, and quality measures have sparked interest in
quality outcomes and provided the catalyst for remarkable quality improvement
gains in several long-term care clinical quality measures over the past several
years.
On March 2, 2015 CMS released the 2015 Impact Assessment of Quality
Measures Report.
Dr. Patrick Conway, CMS Deputy
Administrator for Innovation and Quality and Chief Medical Officer,
stated "the 2015 Impact Report demonstrates that the nation has made clear
progress in improving the healthcare delivery system to achieve the three aims
of better care, smarter spending, and healthier people."
The key findings
include:
·
Quality measurement results demonstrate significant
improvement. 95 percent of 119 publicly reported performance
rates across seven quality reporting programs showed improvement during the
study period (2006–2012). In addition, approximately 35 percent of the 119
measures were classified as high performing, meaning that performance rates
exceeding 90 percent were achieved in each of the most recent three years for
which data were available.
·
Race and ethnicity disparities present in 2006 were
less evident in 2012. Measure rates for Hispanics, Blacks and Asians
showed the most improvement, and American Indian/Native Alaskans and Native
Hawaiian/Pacific Islanders the least improvement. Transparency and monitoring
of measures rates by race and ethnicity for all publicly reported measures and
ensuring that disparities across programs, setting and demographic groups are
eliminated, remain top priorities consistent with our CMS Quality
Strategy.
·
Provider performance on CMS measures related to heart
and surgical care saved lives and averted infections. From 2006
to 2012, 7,000 to 10,000 lives were saved through improved performance on
inpatient hospital heart failure process measures, and 4,000 to 7,000
infections were averted through improved performance on inpatient hospital
surgical process measures. (A number of the measures are also included in the previously
released patient safety results demonstrating from 2010 to 2013 a 17
percent reduction in patient harm, representing 1.3 million adverse events and
infections avoided, approximately 50,000 lives saved, and an estimated $12
billion in cost savings.)
·
CMS quality measures impact patients beyond the
Medicare population. Over 40 percent of the measures used in CMS quality
reporting programs include individuals whose healthcare is supported by
Medicaid, and over 30 percent include individuals whose healthcare is supported
by other payer sources. This demonstrates the public-private collaboration that
CMS facilitates and hopes to expand.
·
CMS quality measures support the aims of the National
Quality Strategy (NQS) and CMS Quality Strategy. CMS quality
measures reach a large majority of the top 20 high-impact Medicare conditions
experienced by beneficiaries, with more measures directed at the six measure
domains related to the NQS priorities, and better balance among those domains.
Much of our data resulted from process measures; however, there is an increase
in measures related to patient outcomes, patient experience of care, and cost and
efficiency. CMS is moving increasingly toward these outcome measures across
programs.
The 2015 report can be
found at:
I am personally very heartened by these
findings and feel them in my everyday work.
This past week I attended a system collaborative meeting where the top
leaders in my acute care system came together to discuss "Just
Culture," national safety initiatives, strategies for involving staff in
changing practices around near miss events and staff satisfaction survey
results that will impact the future of quality and safety work in our
organization. This work is amazing to me
and the outcomes are improving with a lot of hard work by many dedicated
people.
In closing I would like to share a
quote from my healthcare quality hero, Dr. Avedis Donabedian. In an interview with Health Affairs one month
before his death he said:
"Systems awareness and systems design are important for
health professionals, but they are not enough. They are enabling mechanisms
only. It is the ethical dimensions of individuals that are essential to a
system’s success. Ultimately,
the secret of quality is love. You have to love your patient, you have to love
your profession, you have to love your God. If you have love, you can then work
backward to monitor and improve the system."
Contributed by
Tammy Rolfe, Adjunct Professor, St. Josephs
College
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